The role of choice in health education intervention trials: a review and case study

Janevic, Mary R.; Janz, Nancy K.; Dodge, Julia A.; Lin, Xihong; Pan, Wenqin; Sinco, Brandy; Clark, Noreen M.

doi:10.1016/s0277-9536(02)00158-2

Cited by 89 publications

(97 citation statements)

References 33 publications

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“…Those preferring the Self Directed format tended to have better symptom profiles but poorer functioning scores. Observations are consistent with previous findings [5]. Table 5 shows that at four months women who preferred the Group format (would chose the Group format if given the choice) had significantly better SIP psychosocial functioning when they received the Group format than when they were assigned to the Self-Directed format (difference = 4.85, p=0.03).…”

Section: (B) Women Given a Choice Of Intervention Versus Those Assignsupporting

confidence: 89%

“…Process data from the study, reported elsewhere [5], indicated that, after controlling for the effects of sociodemographic variables, participants who chose and got a group format were over four times more likely to attend at least one class and were almost twice as likely to have a higher level of attendance as the women randomized to the group format. Choice of format did not significantly affect completion of the six weekly units for the Self-Directed program participants, nor did it affect whether participants elected to withdraw from the study subsequent to baseline data collection.…”

Section: Discussionmentioning

confidence: 86%

“…How patient preference influences outcome is not precisely understood, but the idea that it does affect results has been posited. A review article [5], for example, suggests that randomized controlled clinical trials of behavioral interventions generally involve a complex set of behaviors (e.g., day to day management of a chronic disease). Behavioral interventions can make differing demands on time, level of commitment and willingness to undertake new, sometimes challenging, tasks.…”

Section: Introductionmentioning

confidence: 99%

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The effect of patient choice of intervention on health outcomes

Clark

Janz

Dodge

et al. 2008

Contemporary Clinical Trials

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Section: (B) Women Given a Choice Of Intervention Versus Those Assignsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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The effect of patient choice of intervention on health outcomes

Clark

Janz

Dodge

et al. 2008

Contemporary Clinical Trials

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“…Dette har ført til, at forskerne er begyndt at forske i patienternes holdninger og valg, deres praeferencer, selvom det stadig sker indenfor en ramme, hvor subjektiviteten betragtes som en fejlkilde. Indtil videre har dette mest haft form af en udvidelse af det traditionelle randomiserede design med yderligere 'arme' bestående af patienter, som har fået lov selv at vaelge deres behandling (Lambert & Wood 2000, Janevic et al 2003, Halpern 2003, King et al 2005.…”

Section: Nye Tendenser I Rku Forslag Om Preference Trials / Selvvalgunclassified

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Gannik¹

2008

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IndledningI denne artikel rettes søgelyset kritisk imod de snaevre ontologiske og epistemologiske opfattelser af sygdom, som er fremherskende i sundhedsvaesenet og i sundhedsforskningen, og hvis legitimitet fortsat understøttes af samfundet, trods at mange års forskning peger på en alt for reduktionistisk tilvejegang til et yderst komplekst faenomen. Kronisk sygdom er et sådant komplekst faenomen, og den

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“…169 Service users typically have little choice about the mode and content of therapy and may be less likely to benefit from treatments they do not choose to receive. 170,171 Service user involvement in mental health and research trials is advocated, 83,172,173 and allowing service user choice is increasingly highlighted as important. 18,19 The partially randomised preference trial design (PRPT 174 ) has been used to enable treatment choice and overcome preference effects in evaluations of various treatments, including psychological therapy.…”

Section: Introductionmentioning

confidence: 99%

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach

Morrison

Law

Barrowclough

et al. 2016

Programme Grants Appl Res

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BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this.ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users.MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme.ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total;p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78;p < 0.006).ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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The role of choice in health education intervention trials: a review and case study

Cited by 89 publications

References 33 publications

The effect of patient choice of intervention on health outcomes

The effect of patient choice of intervention on health outcomes

Untitled

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach

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